Dear
Dr.Saltzman,
I just turned 22 years old, and I live in
Ontario, Canada. I will first try to give you a brief understanding
of my childhood so that maybe you can understand me a little bit, I
will try to make this as short as possible.
I moved out on my own
a few years ago now for school living in residence, and have been
living in my own apartment for 2 years now. When I was younger, I was
diagnosed with Obsessive Compulsive Disorder. I was a 'checker' if
you want to call it that, and I would constantly check to see if I
turned the stove off, unplugged the straightner, emptied the dryer
from ANY fluff possible, and I would do things like this repeatedly,
all the time through out highschool. It would take me at least 45
minutes to walk to school when it was a 10 minute walk because if I
stepped on a certain rock, I would do it again, and again and again.
I would tell myself if I didn't something bad would happen. If I
didn't hear what you said, exactly.. I would repeatedly ask the
question again and again to the point that people were getting upset
with me. I was also a germaphobe, and I was always making sure things
were 'just so'. I was really, really annoying and my mother always
thought I was doing things intentionally to bother her, but the fact
was that if I didn't do certain things, I would actually break
down.
It got to the point that when I was dating my boyfriend
of 2 years in highschool, I couldn't even watch television or bump
into another male at school without thinking that I was cheating on
him. In my mind I deep down knew I wasn't, but I couldn't get it out
of my head and would have to inform him of ANYTHING like that, that I
did..It was horrible.
I was put on a medication called fluvoxamine
when I was about 16, and it helped a lot and over time my 'ticks'
started to go away less and less. I started to finally live a normal
life for the next few years, my ocd would come and go as it pleased
but with enough cognitive behavioural therapy, etc I was able to at
least be in control of my life.
About 2 years ago now, my OCD
started making small appearances in my life. I lived a fairly normal
teenage life, I didn't excessively drink, or do drugs but I did try
drugs a few times and smoked marijuana sometimes as well but I was
never, ever an addict to anything. I tried ecstasy and cocaine a few
times, mostly in my first year of college. I can honestly say that it
was never a huge thing, and I only did it a few times but I feel it
necessary to talk about just incase it has anything to do with how I
am feeling now. However, one night after doing one line of cocaine I
had my first panic attack. It was the scariest, worst thing I have
EVER been through. I haven't touched it since, and it has been almost
2 years now. Since then, I have had such bad panic attacks, and
anxiety. SUCH severe anxiety, I can't even begin to explain. Last
year around this time I had swine flu, and during that time I had
such bad anxiety and because of my heart rate was in and out of the
hospital like you wouldn't believe. I was sick in bed for almost a
month and a half, and was later put on sick leave due to my illness
of swine flu, and my doctor 'diagnosed' me with severe panic
disorder. Which has been only the beginning to my nightmare. I
started taking a pill called Cipralex which seemed to help intensely,
but only for short periods of time and then its like it wares off or
something. I also have lorazapam for onset anxiety, but I only take
it when needed. My panic attacks have reduced a significant amount,
but now my OCD is back in full force and ruining my life. A few weeks
ago they changed my medication to Wellbutrin XL, because some side
effects of cipralex I disliked. Around that time my friend's uncle
died, and she called to talk to me about it and I tried to comfort
her any way I could and afterwards, all I could find myself doing was
thinking about dying. Death was constantly on my mind, and even know
just typing it I can feel my self beginning to panic. I can't get it
out of my head. All I think about, all day is dying. What its like,
what it feels like, how everyone is just so comfortable with it, and
why all of a sudden I'm having such an issue with it. I realize its a
part of life, but I can't seem to get it out of my head and its
gotten to the point that I can't sleep, eat, be touched. It is
ruining my relationship with my boyfriend, and causing me such stress
in my life that I had to quit my job at a retirement home because I
just couldn't bear working with people that were so fragile and old
without panicking. My parents are so disappointed in me, and I feel
as if noone understands what I'm going through. I actually, seriously
feel like I am going insane. I will just be sitting there, and start
thinking the weirdest thoughts.. I will think that every day normal
things, are strange and awkward. I am starting to scare myself. I
went off Wellbutrin about 2 weeks ago now, and have started Cipralex
again and it has helped a little but I am still awake at all hours of
the night. (right now it is 2 am) I can't just 'clear my head' or
'not think about it' as millions like to tell me to do. I just want
to feel normal again, and have passion for things in life, and want
to wake up in the morning. Instead, I am feeling as if everything is
pointless because one day I am just going to get old, and DIE. I am
so scared. I have no thoughts of hurting myself, as I am far too
afraid of the thought of dying, but I just don't know what to do
anymore.
I'm afraid I am going to have to admit myself to some
kind of mental institute. I know I am young, but I just don't feel
okay..
Please HELP.
I am so sorry for the huge novel I have
written, I have so much going through my head. If you do not have
time to write back, I understand.
Thanks for reading,
Amanda
Hello, Amanda--
I am sorry to hear about all this suffering. Obsessive-Compulsive Disorder (OCD) usually is understood as having a genetic basis, and the treatment you have received—a combination of medication and cognitive behavioral therapy (CBT)--is widely considered the most effective way to deal with it. Apparently, that combination of therapy and medication did work reasonably well for you for a while, so I suggest right off the bat that you get back into therapy right away, and also ask the doctor who has been prescribing your medication to try another substance which might work better in controlling your symptoms.
It is possible that your experiment with cocaine triggered the panic attack, so, obviously, you should not mess around with any "recreational" drugs again.
Fear of death is a common human experience. So is the thought that, since some day I will die, there is no point in living. Both of these kinds of suffering need to be addressed not with drugs, but by means of psychotherapy and/or some kind of philosophical or spiritual healing practice. In your case, which is complicated by your tendency to obsess on your thoughts, and to become compulsive in trying to deal with them, I would recommend that you look for a psychotherapist with whom you can meet on a regular basis—perhaps several times a week at first. If you can do this as an outpatient, so much the better, but a hospital setting, at least for a short time, could also provide the kind of care you need.
